Exploring the “Crack Baby” Myth

May 22, 2008

The notion that the “crack baby” scare of the 1980s and 1990s was overblown and more than a little racist isn’t exactly new, but the content of the debate and current medical understanding of the situation hasn’t exactly been publicized with the same vigor as the initial “epidemic.” I’ll be doing some reading on this over the weekend, but I want to comment here on a case National Advocates for Pregnant Women has been involved with – that of Regina McKnight, who was convicted in South Carolina in 2001 of homicide by child abuse. After an unintentional stillbirth in 1999, it was claimed that her cocaine use was the cause, and McKnight was given a 20 year sentence (with some of those years suspended).

The May 12th court opinion on McKnight’s case – which reversed her conviction – focuses primarily on whether she had adequate representation, which is certainly an important issue. I want to draw attention today to the section on the autopsy report, which was not introduced into evidence in the original case.

We find that the autopsy was a powerful piece of documentary evidence that was crucial to McKnight’s defense because it contradicted the State’s theory of the case. The State’s own expert authored the autopsy report which listed three causes of death: chorioamnionitis, funisitis, and cocaine. After McKnight’s own expert could not rule out cocaine as a cause of death, the autopsy report itself would have served as hard evidence to (1) undermine the conclusion of Dr. Woodard, the only expert who opined that cocaine alone caused the fetal demise, and (2) remind jurors of the inconsistencies in the State’s experts’ testimony.

For a broader picture, read the section on “Failure to prepare an adequate defense” – it explains that while only one of the medical experts claimed to know with certainty that cocaine exposure caused the stillbirth, the State argued in closing that “Dr. Conradi’s failure to eliminate cocaine as a cause of fetal demise and declared that in conjunction with the testimony of Dr. Woodard, Dr. Conradi ‘really helped us out in figuring out the cause of death in this particular case’ by eliminating all other relevant causes of death.” Dr. Conradi, according to the court opinion, had actually indicated that she would have ruled the cause of death as “undetermined” rather than homicide and that it was “unlikely, but possible” that the chorioamnionitis and funisitis led to the stillbirth.

Another medical expert explained “doctors’ recognition of recent studies showing that cocaine is no more harmful to a fetus than nicotine use, poor nutrition, lack of prenatal care, or other conditions commonly associated with the urban poor.”
Despite the complexities and medical uncertainties in determining the actual cause of death, the jury returned a guilty verdict in just 30 minutes.